Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033687 (proteinuria)
 24,015 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An imported case of Schistosoma haematobium infection presenting with haematuria and proteinuria is described. This would constitute a first case of urinary schistosomiasis in Malaysia. The patient failed to respond to multiple antibiotic treatment and was successfully treated with praziquantel.
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PMID:Schistosoma haematobium infection in Malaysia--a case report. 130 89

Severity of urinary tract morbidity increases with intensity and duration of Schistosoma haematobium infection. We assessed the ability of yearly drug therapy to control infection intensity and reduce S. haematobium-associated disease in children 5-21 years old in an endemic area of Kenya. In year 1, therapy resulted in reduced prevalence (66% to 22%, P < 0.001) and intensity of S. haematobium infection (20 to 2 eggs/10 mL urine), with corresponding reductions in the prevalence of hematuria (52% to 19%, P < 0.001). There was not, however, a significant first-year effect on prevalence of urinary tract abnormalities detected by ultrasound. Repeat therapy in years 2 and 3 resulted in significant regression of hydronephrosis and bladder abnormalities (41% to 6% prevalence, P < 0.01), and further reductions in proteinuria. Repeat age-targeted therapy was associated with decreased prevalence of infection among young children (< 5 yr) entering into the targeted age group. Two years after discontinuation of therapy, intensity of S. haematobium infection and ultrasound abnormalities remained suppressed, but hematuria prevalence began to increase (to 33% in 1989). Reinstitution of annual therapy in 1989 and 1990 reversed this trend. We conclude that annual oral therapy provides an effective strategy for control of morbidity due to S. haematobium on a population basis, both through regression of disease in treated individuals, and prevention of infection in untreated subjects.
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PMID:Age-targeted chemotherapy for control of urinary schistosomiasis in endemic populations. 134 96

Information regarding glomerular lesions related to Schistosoma haematobium infection in man or animal are extremely lacking and disputed. The objective of this experimental study was to investigate glomerular lesions in S. haematobium-infected golden hamsters. In this work, 53 hamsters were infected with S. haematobium cercariae and 18 animals of similar age and sex served as controls. Hamsters were infected either with 50, 200, 300, 400 or 600 cercariae and sacrified after 8, 9, 10, 14, 18, 24 or 32 weeks. Infected and control hamsters were subjected to laboratory examinations including serum creatinine, serum albumin, total protein, serum cholesterol, total urine protein as well as histopathologic evaluations. Kidney biopsies were examined by light microscopy, indirect immunofluorescence and by electron microscopy. Significant proteinuria, hypoalbuminaemia and hypercholesterolaemia were observed in all but 5 S. haematobium-infected, but in none of the control hamsters. Renal impairment was observed in 5 hamsters. Histopathologic evaluations showed IgG, circulating anodic antigen and circulating cathodic antigen deposits in the renal glomeruli. By electron-microscopic examination, these deposits were seen mainly in the subendothelial, mesangial and paramesangial areas. Amyloid deposits were also seen in the renal glomeruli, tubular basement membrane and in the interstitium. A correlation was found between the extent of amyloid deposition and the duration but not the intensity of schistosomal infection. We have concluded that S. haematobium infection can lead to glomerulopathy in golden hamsters.
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PMID:Schistosoma haematobium-induced glomerular disease: an experimental study in the golden hamster. 190 86

Reinfection pattern among 6- to 20-year-old subjects was studied over 24 months in two Mauritanian villages of intense Schistosoma haematobium infection after a targeted chemotherapy with praziquantel involving the whole community. Subjects received treatment according to the presence of haematuria/proteinuria and this indirect screening technique was able to identify 98-100% of the heavily infected subjects (50 + eggs/10 ml). The two villages differed with respect to their characteristics, quality of follow-up and reinfection pattern. The post-treatment 6-month cumulative incidence during the two transmission periods following the chemotherapy, estimated from a subset of 116 subjects, was 18.0% and 20.5%. Reinfection rates were higher among males (Cox-Mantel: P = 0.0015), among children 6-10 years of age than older (P = 0.0078) and among subjects with more than 50 eggs/10 ml of urine before treatment than subjects with a lower egg output (P = 0.009). A Cox proportional hazard regression model was fitted and confirmed that gender, age and pretreatment level of infection were predictors of the rate of reinfection but that there was no interaction between these predictors.
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PMID:Schistosoma haematobium infection in Mauritania: two years of follow-up after a targeted chemotherapy--a life-table approach of the risk of reinfection. 211 11

To determine the relative efficacy of metrifonate and praziquantel in controlling urinary tract morbidity due to Schistosoma haematobium infection, a random allocation treatment trial was performed among 1,813 school age S. haematobium-infected children from the Msambweni area of Coast Province, Kenya. Following baseline examination for infection, hematuria, proteinuria, and ultrasonographic urinary tract abnormalities, oral treatment with either metrifonate (10 mg/kg, repeated at 4 month intervals) or praziquantel (1 dose of 40 mg/kg) was given to infected subjects. Prevalence of morbidity was reassessed 12 months later for each treatment group. Results indicated equivalent patient improvement in response to either regimen: prevalence of hematuria fell from 75% to 17% after either praziquantel or metrifonate therapy. Similarly, prevalence of proteinuria was significantly reduced from 73% to 29% (metrifonate) or 27% (praziquantel) after therapy. Metrifonate and praziquantel caused similar reductions in bladder granulomata and bladder thickening; however, no reduction in hydronephrosis was noted with either drug. Analysis of outcomes in population subgroups defined by age, sex, pretreatment intensity of infection, or severity of pretreatment morbidity showed no consistent advantage for either drug. In this endemic area, both agents provide effective control of morbidity due to urinary schistosomiasis.
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PMID:Chemotherapy-based control of schistosomiasis haematobia. II. Metrifonate vs. praziquantel in control of infection-associated morbidity. 211 8

Examination of urine samples from 922 children from Epe and surrounding communities in south-western Nigeria indicated a 13% prevalence of Schistosoma haematobium infection. Children, 10-14 years of age, accounted for 65% of the disease prevalence. Approximately 79% of the study population was negative for proteinuria, while 52.6% of children with 30 mg% proteinuria were positive for S. haematobium infection. However, 96% and 100% of all children who, respectively, had 30 mg% and 100 mg% proteinuria, in addition to haematuria, were found to be positive for the schistosome infection. This finding indicates that the use of haematuria and proteinuria as a combined diagnostic index significantly increased the sensitivity and specificity of the individual tests. Bacteriuria was found in 8.5% of infected children, compared with 5.2% of the control group. Streptococcus faecalis and E. coli were the two bacteria isolated from the urine specimens.
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PMID:Proteinuria and haematuria as predictors of schistosomiasis in children. 247 60

The association between glomerular disease and hepatosplenic schistosomiasis is well documented in reports from South America. During the present hospital investigation in Sudan, 58 patients admitted for intercurrent complications of advanced hepatosplenic schistosomiasis were studied. The patients, median age 35 years, had no concurrent Schistosoma haematobium infection. Diagnostic criteria included an enlarged spleen (n = 58), at least 1 episode of hematemesis (n = 55) and/or melena (n = 36), endoscopical demonstration of gastroesophageal varices (29/29 studied), ultrasonographical imaging of hepatic periportal fibrosis (18/18 studied), and intraoperative liver biopsy with characteristic histological findings (11/16 biopsied). Serum creatinine, urea, electrolytes, cholesterol, total protein, and electrophoresis were within normal limits. Median urinary protein/creatinine ratio was 0.06 and thereby not significantly different from European reference values. Only 1 patient had proteinuria of 1.7 g/l. Minimal hematuria was found in 5 patients. Ten kidney biopsies were taken intraoperatively during a portal decompression procedure (Hassab operation). Light, immunofluorescence, and electron microscopy produced no evidence of glomerulonephritis. These findings indicate that S. mansoni induced nephrotic syndrome may be less frequent in Sudan than in South America. Renal involvement due to S. mansoni infection may therefore encompass geographical variances.
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PMID:Renal function and morphology in Sudanese patients with advanced hepatosplenic schistosomiasis and portal hypertension. 249 2

Proteinuria was studied in 128 children aged 6 to 18 years with Schistosoma haematobium infection in the People's Republic of Congo. Urinary protein concentration in spontaneously voided midday urine of patients with greater than 100 ova/10 ml was significantly higher than in 24-hr urine specimens. Median daily urinary protein loss in patients with moderate intensity of infection (100-350 ova/10 ml) was 300 mg and 584 mg/1.73 m2 body surface in heavily infected patients (greater than 350 ova/10 ml). A significant correlation existed between egg excretion at noon and protein concentration in spontaneous urine samples as well as daily urinary protein loss (r = 0.76 and r = 0.68, respectively). Heavily infected patients had a daily protein loss of up to 3.3 g/1.73 m2, total serum protein and albumin concentration, however, were within normal limits. This may indicate adaptive mechanisms in patients with urinary schistosomiasis and high proteinuria which maintain a balanced serum protein concentration.
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PMID:Daily urinary protein loss in Schistosoma haematobium infection. 309 95

The use of urinalysis reagent strips (Labstix; Ames) in screening for Schistosoma haematobium infection in various schistosomiasis-endemic areas of the RSA was assessed in 941 children. Sensitivity, specificity, false-positive and false-negative rates and the positive predictive value for haematuria and proteinuria were calculated. Both haematuria and proteinuria were positively correlated with the presence of S. haematobium eggs in the urine. Intensity of infection correlated positively with the degree of haematuria and proteinuria (P less than 0.001). The presence and intensity of S. haematobium infection were more closely related to the presence and degree of haematuria than to proteinuria. Screening for haematuria alone enabled 83.1% of S. haematobium-positive and 89.7% of negative subjects to be detected accurately. The false-positive rate was 2.7%. It was found that a single parameter, haematuria, could be used to identify infected children in endemic areas. It was also found to be possible to use the reagent strips to select out S. haematobium-infected children with egg counts greater than 200 ova/10 ml urine. The simple model developed allows rapid identification of moderately to heavily infected children and can be used by paramedical staff in field situations.
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PMID:Urinalysis reagent strips in the screening of children for urinary schistosomiasis in the RSA. 311 82

The relationship of haematuria and proteinuria to intensity of Schistosoma haematobium infection, the possibility of using haematuria and proteinuria for diagnosing S. haematobium infection, and the value of haematuria and proteinuria in assessing chemotherapeutic efficacy after treatment with praziquantel were studied in 235 male and female schoolchildren, 9-to 14-year old. A correlation was found between both severity of dipstick proteinuria/haematuria and frequency of visible haematuria, and intensity of S. haematobium infection. Haematuria and proteinuria proved reasonably sensitive indicators of urinary schistosomiasis (78% and 86% respectively) and both techniques detected all heavy infections (over 64 eggs/10 ml urine), but haematuria was considered the overall better indicator due to its greater specificity before (83% vs 64%) and after (78% vs 67%) treatment. The presence of visible haematuria detected 19% of all infected children and two-thirds of those passing more than 64 eggs/10 ml urine, and can provide a useful saving of time and the use of reagent strips. Comparison of the results with those obtained elsewhere confirmed regional differences in the intensity of infection inducing specific levels of haematuria/proteinuria and in the sensitivity and specificity of urinary blood and protein as indicators of infection.
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PMID:Haematuria and proteinuria during Schistosoma haematobium infection: relationship to intensity of infection and the value of chemical reagent strips for pre- and post-treatment diagnosis. 312 Mar 68


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